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Is a trip to a neurosurgeon really right? Please maybe you can make a s...
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Is a trip to a neurosurgeon really right? Please maybe you can make a suggestion?

    The diagnosis I have received are carpal tunnel, bulging discs at C4,C5 and arthritis in my neck as well. And maybe lyme though i am a bit confused on that, my symptoms have been going on for years and the IGG test came up negative and the IGM came up positive. The only other test that ever comes up out of range is CK usually in 200's.

    What I would like to know is can neck problems cause weakness not just in my arms and hands but in the rest of my body, can it cause my toes to burn and extreme fatigue and can it cause vision problems. My vision has been getting steadily worse and I am terrified. I can no longer successfully track a fast moving objects. i would also like to know if having idiopathic edema could have an effect on the nervous system and cause the above symptoms or be in any way related. thanks so much! I really appreciate your answer.
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Avatar dr f tn
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to obtain a history from you and examine you, I can not comment on whether or not you need surgery for your disc. however, I will try to provide you with some information regarding this matter.

There is a material that cushions the space occurring between the vertebra (bones of the spine). This material may sort of be squished out from in between the two bones; this is called a herniated disc. The disc may push on surrounding structures, namely the spinal cord and/or the nerves exiting from the spinal cord. Most often, it is the nerves that are pressed on, and not the spinal cord itself.

In most people, the pain of a herniated disk resolves over 4-6 weeks. The most severe pain actually eases up within 1-2 weeks. Only a minority of people every require surgery. With time, the amount of disk that has herniated shrinks and with time resolves completely in most people. Therefore, for the majority of people, non-surgical treatment is the first option. This treatment may include medications (non-steroidals such as advil), sometimes steroids if there is swelling (edema), temperature therapy (hot or cold packs), stretching and controlled physical therapy, muslce relaxants, and so on, these are best prescribed by an experienced physician, each has its own indications.

In a minority of patients, surgery needs to be done urgently. This often is the case when the herniated disc is pressing on the spinal cord itself. Surgery is emergent so that permanent spinal cord injury does not occur. Another indication for urgent surgery is if there evidence that a nerve is being compressed on to the point that its function is impaired. Symptoms suggesting the need for urgent surgery includes muscle weakness, loss of bowel or bladder control, loss of sensation, particularly in the pelvis and severe and progressive pain.

One means of assessing whether or not the nerve being pressed on by your herniated disc is impaired is a test called an EMG/NCS which assesses how fast the nerve conducts electricity and how the muscle responds. This type of test is done by neurologists in most centers.

In some patients, after conservative non-surgical therapy is tried for 4-6 weeks and the pain is still severe or if other symptoms/indications arise, surgery is the next step.

It would be best for you to discuss surgical and non-surgical options with your physician.

Disc Herniations do not cause vision changes.  Therefore, I would recommend seeing your physician for those symptoms.  You may need to have a full eye exam by a ophthalmologist.  

Lyme IgM represents a new active infection or an existing infection that has become reactivated.  Some of your fatigue may be related to this, however other causes should also be ruled out:  Thyroid conditions, vitamin deficiencies, or other systemic causes (anemia, liver problems, etc.). Some long term effects can include numbness and tingling.  

I would recommend asking your physician whether you qualify for treatment.

I hope this information was helpful.  Good luck.  
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